Cigarette Smoking in the Adolescent Children of Drug

7/30/2019 Cigarette Smoking in the Adolescent Children of Drug

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Cigarette smoking in the adolescent

children of drug-abusing fathers.Pediatrics 117.4 (April 2006): p1339(9). (6668 words)

Characteristics of the Sample

Demographic information on the adolescents who participated at both time waves andtheir fathers indicated that 76.4% of the fathers reported a lifetime history of injectiondrug use at time 1; the remainder (23.6%) of the fathers had used drugs through anotherroute of administration, such as crack smoking. A total of 85% (n = 253) had a history ofcocaine use, and 73% of fathers (n = 216) reported lifetime use of heroin. A total of 77%(n = 228) of fathers reported having ever been in treatment at time 1. The average age forfathers at time 1 was 42.1 years (SD: 6.5), and their median educational level was thecompletion of high school or obtaining a GED. Occupational analysis indicated that only

37% of fathers were employed at the time of the interview (24% full time and 13% parttime); the rest (63%) were unemployed, looking for work, retired, keeping house, or intreatment full time. Their median household income range was $10 000 to $15 000 perannum. A total of 57% of the father-child pairs resided together. The average age for theadolescents at time 1 was 16.3 years (SD: 2.8) and at time 2 was 17.2 years (SD: 2.8). Atotal of 51.7% of adolescent participants at time 2 were male. The median educationallevel for the adolescents at time 2 was the 10th grade. According to the adolescents'reports, the ethnicity of the father-child pairs was 47.3% black, 44.0% Hispanic, 7.4%non-Hispanic white, and 1.3% other.

Our results suggest that paternal tobacco and illicit drug use may have an adverse impacton the father's childrearing practices and the establishment of a predominantly warm andnonconflictual relationship with his adolescent child. Fathers who smoke cigarettes maybe less likely to have or to enforce antismoking rules for their child, (55) and theadolescent may be more likely to smoke in the absence of such rules. (13) In addition, thefather may be more focused on procuring and taking illegal drugs than on his child'seducation and welfare. The adolescent child may also have less identification (defined inour study as admiration and emulation) with a father who is abusing drugs. There iscurrently scant empirical research on the father-child relationship in the context ofpaternal drug use, (56) and even fewer studies, to our knowledge, have specifically

looked at adolescent smoking as the outcome of interest. In a related vein, however,Rotheram-Borus et al (57) examined the parent-child relationship in HIV-positivemothers and fathers, most of whom were drug users, and found that current parental druguse was highly associated with parent-child conflict. Brook et al (58) also found thatparental illicit drug use was inversely related to positive aspects of the parent-child bondin a community sample of young mothers and fathers and their children. In addition, ourresults are consistent with the few investigations of the mediational role of the parent-child relationship in the adjustment of the children of drug-using parents. Fals-Stewart et
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al, (2) for instance, showed that interparental conflict and poor parenting skills linkedpaternal substance use with internalizing and externalizing symptoms in theirpreadolescent children. Similarly, Suet al (21) found that negative life events anddecreased family cohesion mediated the longitudinal association between maternal and/orpaternal substance use disorders and both depression in and the use of alcohol and illicit

drugs by their early adolescent child. (Of note is that these researchers also found a directlink between parental and offspring substance use, similar to our own finding.) Takentogether with the present study, these preliminary results on the children of drug userspoint to the impact of paternal drug use on the father-child relationship, as well as theimportance of the father-child bond to the adolescent's psychological adjustment. Ourresults suggest that paternal tobacco and illicit drug use may have an adverse impact onthe father's childrearing practices and the establishment of a predominantly warm andnonconflictual relationship with his adolescent child. Fathers who smoke cigarettes maybe less likely to have or to enforce antismoking rules for their child, (55) and theadolescent may be more likely to smoke in the absence of such rules. (13) In addition, thefather may be more focused on procuring and taking illegal drugs than on his child's

education and welfare. The adolescent child may also have less identification (defined inour study as admiration and emulation) with a father who is abusing drugs. There iscurrently scant empirical research on the father-child relationship in the context ofpaternal drug use, (56) and even fewer studies, to our knowledge, have specificallylooked at adolescent smoking as the outcome of interest. In a related vein, however,Rotheram-Borus et al (57) examined the parent-child relationship in HIV-positivemothers and fathers, most of whom were drug users, and found that current parental druguse was highly associated with parent-child conflict. Brook et al (58) also found thatparental illicit drug use was inversely related to positive aspects of the parent-child bondin a community sample of young mothers and fathers and their children. In addition, ourresults are consistent with the few investigations of the mediational role of the parent-child relationship in the adjustment of the children of drug-using parents. Fals-Stewart etal, (2) for instance, showed that interparental conflict and poor parenting skills linkedpaternal substance use with internalizing and externalizing symptoms in theirpreadolescent children. Similarly, Suet al (21) found that negative life events anddecreased family cohesion mediated the longitudinal association between maternal and/orpaternal substance use disorders and both depression in and the use of alcohol and illicitdrugs by their early adolescent child. (Of note is that these researchers also found a directlink between parental and offspring substance use, similar to our own finding.) Takentogether with the present study, these preliminary results on the children of drug userspoint to the impact of paternal drug use on the father-child relationship, as well as theimportance of the father-child bond to the adolescent's psychological adjustment.


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Smoking frequency, prevalence and

trends, and their socio-demographic

associations in Alberta, Canada.(QUANTITATIVE RESEARCH)

(Report).

As shown, both the smoking prevalence and the number of smokers were higher amongmen than women, in middle-aged groups (20-39 and 40-59 years) than in younger (12-19years) and older (>60 years) groups, and among Canadian-born people than immigrantsto Canada

The above associations were further examined using logistic regression (Table 3). Asshown, the odds of being a smoker were significantly lower in women than men andabout four times higher in those aged 20-39 and 40-59 years than in those aged 12-19years and 60 years or older.

Smoking cessation: priorities in primary

care: this article will focus on the role of

brief advice, before discussing specific

issues relating to smoking cessation inhigh-prevalence groups, which include

manual workers, adolescents and

pregnant women.(smoking cessation).

In developed countries, there is a strong correlation between smoking and socioeconomicclass, primarily because the decline in overall smoking rates seen since the middle of the20th century has been mainly concentrated in the higher socio-economic groups.

In 2002, in western Europe, the highest smoking prevalence was among the unemployed(54%) and manual workers (51%). In the UK, in 2006, 28% of manual workers smokedcompared with 17% of non-manual workers, with the difference between social classesbeing even greater- only 15% of those in higher professional or managerial householdssmoked, compared to 29% in a routine or manual occupation. (5) There are also


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differences in the amount smoked and the type of smoking between social classes (Table2).

Motivation to quit is similar across social groups, but poorer people who smoke cannotbe blamed for failing to quit because they have lower motivation. As people from lower

socio-economic backgrounds who smoke tend to be more seriously addicted to nicotine,there may be even greater justification for using pharmacotherapy in this group. (7)

In the UK, the most marked reduction in the smoking rate has been among people overthe age of 35 years. (8) In 2006, the lowest rate (12%) was among those aged 60 yearsand over, possibly because non-smokers tend to live longer. Among those aged 16-19, itwas 20%, the rate remaining highest in 20-24-year-olds at 31%. (5)

Children become aware of cigarettes at an early age, even if their parents do not smoke.However, children are three times more likely to smoke if their parents are smokers,while peers and older siblings are also influential. (8) At the age of 11 years, at the start

of secondary school, only 1% of children are regular smokers. By the time they reach 15years old, however, the likelihood of them smoking regularly is 20%. (9) Although in thepast 10 years the proportion of teenagers who smoke has declined, most of this decreasehas been in boys.

The smoking rate in children gives an indication of the likely adult rate in years to come--about 40% of adult smokers started smoking before the age of 16 years. (6) Furthermore,the earlier smoking starts, the greater the potential damage. (9) Young people who smokeare aware of the health risks of smoking and most would like to stop. Although youngpeople who smoke report smoking few cigarettes, many consider themselves to beaddicted to tobacco and believe that stopping would be difficult. Young people who

smoke are also more likely to drink alcohol or take illicit drugs. (7)

Tobacco, alcohol and illicit drug use

among aboriginal youth living off-

reserve: results from the Youth Smoking

Survey.(Research)(Survey

Of the 28 843 respondents in grades 9 to 12 who answered the item about Aboriginalstatus, 2620 (9.1%) identified themselves as Aboriginal: 1408 (53.7%) were FirstNations, 962 (36.7%) were Metis and 250 were Inuit (9.5%). Table 1 presents the samplecharacteristics of the Aboriginal and non-Aboriginal youth in our sample by sex.

Tobacco use


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Overall, 24.9% of the Aboriginal respondents reported that they were current smokers,2.6% were former smokers, and 72.4% were nonsmokers (Table 1). The correspondingproportions among the non-Aboriginal respondents were 10.4%, 1.5% and 88.0%. Theprevalence of smoking was higher among female than among male Aboriginal youth(27.1% v. 22.9%; p = 0.03). Among the respondents who reported having never smoked,

33.4% of Aboriginal youth and 29.0% of non-Aboriginal youth were identified as beingsusceptible to future smoking.